The Clinical and Economic Burden of Antibiotic Use in Pediatric Patients With Varicella Infection: A Retrospective Cohort Analysis of Real-World Data in England

Author:

Kujawski Stephanie A1ORCID,Banks Victoria2,Casey Caroline S2,Drysdale Simon B34,Patel Amisha2,Massey Olivia2,Holbrook Tim2,Pawaskar Manjiri5

Affiliation:

1. Merck & Co., Inc. Center for Observational and Real-world Evidence, , Rahway, New Jersey , USA

2. Real-world Evidence, Adelphi Real World , Bollington , United Kingdom

3. Department of Paediatrics, St George’s University Hospitals NHS Foundation Trust , London , United Kingdom

4. University of London Centre for Neonatal and Paediatric Infection, St George’s, , London , United Kingdom

5. Center for Observational and Real-world Evidence, Merck & Co., Inc. , Rahway, New Jersey , USA

Abstract

Abstract Background Varicella is a highly infectious disease, particularly affecting children, that can lead to complications requiring antibiotics or hospitalization. Antibiotic use for varicella management is poorly documented. This study assessed antibiotic use for varicella and its complications in a pediatric population in England. Methods Data were drawn from medical records in the Clinical Practice Research Datalink and Hospital Episode Statistics data sets. The study included patients <18 years old with varicella diagnosed during 2014–2018 and 3-month follow-up available. We determined varicella-related complications, medication use, healthcare resource utilization, and costs from diagnosis until 3 months after diagnosis. Results We identified 114 578 children with a primary varicella diagnosis. Of these, 7.7% (n = 8814) had a varicella-related complication, the most common being ear, nose, and throat related (37.1% [n = 3271]). In all, 25.9% (n = 29 706 of 114 578) were prescribed antibiotics. A higher proportion of patients with complications than without complications were prescribed antibiotics (64.3% [n = 5668 of 8814] vs 22.7% [n = 24 038 of 105 764]). Mean annualized varicella-related costs were £2 231 481 for the study cohort. Overall, antibiotic prescriptions cost approximately £262 007. Conclusions This study highlights high antibiotic use and healthcare resource utilization associated with varicella management, particularly in patients with complications. A national varicella vaccination program in England may reduce varicella burden and related complications, medication use, and costs.

Funder

Merck Sharp & Dohme

Merck & Co

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Immunology and Allergy

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